Provider Demographics
NPI:1891297909
Name:PATEL AND BYUN, A DENTAL CORPORATION
Entity Type:Organization
Organization Name:PATEL AND BYUN, A DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JUNG WOOK
Authorized Official - Middle Name:
Authorized Official - Last Name:BYUN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-878-6680
Mailing Address - Street 1:5785 SPRING MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-8804
Mailing Address - Country:US
Mailing Address - Phone:702-368-3854
Mailing Address - Fax:
Practice Address - Street 1:5785 SPRING MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-8804
Practice Address - Country:US
Practice Address - Phone:702-368-3854
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-05
Last Update Date:2018-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty